Gum Grafting Procedures
Craig H. Rubinoff, DDS, MS – Poway CA
When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an option.
When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost.
In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance of the gum and tooth. When significant, gum recession can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.
Subepithelial Connective Tissue Grafts
A Gingival Graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth or gently moved over from adjacent areas to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.
In many cases, a grafting material other than your own tissue (a Dermal Allograft) can be used to augment the site of recession. This eliminates the need to use the roof of the mouth as a secondary surgical site to obtain the graft tissue.
The Gingival Graft procedure is highly predictable and results in a stable healthy band of attached tissue around the tooth.
A frenum is a naturally occurring muscle attachment, normally seen between the front teeth (either upper or lower).
A frenum is a naturally occurring muscle attachment, normally seen between the front teeth (either upper or lower). It connects the inner aspect of the lip with the gum. A lack of attached gingiva, in conjunction with a high (closer to the biting surface) frenum attachment, which exaggerates the pull on the gum margin, can result in recession. Additionally, an excessively large frenum can prevent the teeth from coming together resulting in a gap between the front teeth. If pulling is seen or the frenum is too large to allow the teeth to come together, the frenum is surgically released from the gum with a Frenectomy. Often a Gingival Graft is added to re-establish an adequate amount of attached gingiva.
When Orthodontic treatment is planned or initiated, the removal of an abnormal frenum, with or without a gingival graft, can increase stability and improve success of the final orthodontic result.
Another type of frenum is the lingual frenum which can attach the tip of the tongue too close to the inner gingiva of the lower front teeth. This results in a Tongue Tie. A Lingual Frenectomy can fix the Tongue Tie.
Dr. Rubinoff uses a Laser to perform Frenectomies. This results in less post-operative bleeding and discomfort as well as faster healing.